面向经颅聚焦超声的多阵元相控阵关键技术

经颅聚焦超声是一种有效的神经调控技术，具有非侵入性、聚焦靶点多和焦点可调控等优势。但由于颅骨的强声衰减和非均质特性，聚焦超声经颅后存在焦点偏移、焦域能量不足以及颅骨烫伤等问题。多阵元超声相控阵可以修正超声经颅后的相位偏差和幅值衰减，实现准确、有效的颅内聚焦。本文首先介绍了换能器的阵元排布方式，进一步归纳了相控阵激励信号的调控方法，最后对其基础研究和临床应用进行了回顾与展望。     

Ultrasound, microbubbles and the blood-brain barrier

The blood–brain barrier (BBB) is a specialized system of capillary endothelial cells that protects the brain from harmful substances in the blood stream, while supplying the brain with the required nutrients for proper function. The BBB controls transport through both tight junctions and metabolic barriers and is often a rate-limiting factor in determining permeation of therapeutic drugs into the brain. It is a significant obstacle for delivery of both small molecules and macromolecular agents. Although many drugs could be potentially used to treat brain disease, there has been no method that allows non-invasive-targeted delivery through the BBB. Recently, promising studies indicate that ultrasound can be used to locally deliver a drug or gene to a specific region of interest in the brain. If microbubbles are combined with ultrasound exposure, the effects of ultrasound can be focused upon the vasculature to reduce the acoustic intensity needed to produce BBB opening. Several avenues of transcapillary passage after ultrasound sonication have been identified including transcytosis, passage through endothelial cell cytoplasmic openings, opening of tight junctions and free passage through injured endothelium. This article reviews the topic of transient disruption of the BBB with ultrasound and microbubbles and addresses related safety issues. It also discusses possible roles of the BBB in brain disease and potential interactions with ultrasound and microbubbles in such disease states.     

Method of local action by focussed ultrasound on deep brain structures in unrestrained unanesthetized animals

A method of local effect of focused ultrasound has been devised for blocking brain structures of an unrestrained experimental animal. The effect of reversible blocking of the visual tract following focused ultrasound was recorded.     

Motor Enrichment and the Induction of Plasticity Before or After Brain Injury

Voluntary exercise, treadmill activity, skills training, and forced limb use have been utilized in animal studies to promote brain plasticity and functional change. Motor enrichment may prime the brain to respond more adaptively to injury, in part by upregulating trophic factors such as GDNF, FGF-2, or BDNF. Discontinuation of exercise in advance of brain injury may cause levels of trophic factor expression to plummet below baseline, which may leave the brain more vulnerable to degeneration. Underfeeding and motor enrichment induce remarkably similar molecular and cellular changes that could underlie their beneficial effects in the aged or injured brain. Exercise begun before focal ischemic injury increases BDNF and other defenses against cell death and can maintain or expand motor representations defined by cortical microstimulation. Interfering with BDNF synthesis causes the motor representations to recede or disappear. Injury to the brain, even in sedentary rats, causes a small, gradual increase in astrocytic expression of neurotrophic factors in both local and remote brain regions. The neurotrophic factors may inoculate those areas against further damage and enable brain repair and use-dependent synaptogenesis associated with recovery of function or compensatory motor learning. Plasticity mechanisms are particularly active during time-windows early after focal cortical damage or exposure to dopamine neurotoxins. Motor and cognitive impairments may contribute to self-imposed behavioral impoverishment, leading to a reduced plasticity. For slow degenerative models, early forced forelimb use or exercise has been shown to halt cell loss, whereas delayed rehabilitation training is ineffective and disuse is prodegenerative. However, it is possible that, in the chronic stages after brain injury, a regimen of exercise would reactivate mechanisms of plasticity and thus enhance rehabilitation targeting residual functional deficits.     

Effect of Noncompetitive Blockade of N-Methyl-d-Aspartate Receptors on the Neurochemical Sequelae of Experimental Brain Injury

Pharmacological inhibition of excitatory neurotransmission attenuates cell death in models of global and focal ischemia and hypoglycemia, and improves neurological outcome after experimental spinal cord injury. The present study examined the effects of the noncompetitive N-methyl-D-aspartate receptor blocker MK-801 on neurochemical sequelae following experimental fluid-percussion brain injury in the rat. Fifteen minutes after fluid-percussion brain injury (2.8 atmospheres), animals received either MK-801 (1 mg/kg, i.v.) or saline. MK-801 treatment significantly attenuated the development of focal brain edema at the site of injury 48 h after brain injury, significantly reduced the increase in tissue sodium, and prevented the localized decline in total tissue magnesium that was observed in injured tissue of saline-treated animals. Using phosphorus nuclear magnetic resonance spectroscopy, we also observed that MK-801 treatment improved brain metabolic status and promoted a significant recovery of intracellular free magnesium concentrations that fell precipitously after brain injury. These results suggest that excitatory amino acid neurotransmitters may be involved in the pathophysiological sequelae of traumatic brain injury and that noncompetitive N-methyl-D-aspartate receptor antagonists may effectively attenuate some of the potentially deleterious neurochemical sequelae of brain injury.     

An experimental model of pulmonary aspergillosis

The model of experimental chronic pulmonary aspergillosis has been obtained in mice and guinea pigs by the intrapulmonary infection of the animals with the suspension of Aspergillus mycelium and spores in complete Freund's adjuvant. Such method of infection has made it possible to produce chronic local mycotic process. Morphologically, focal inflammatory changes of the lung tissue with the subsequent formation of a multitude of small abscesses in these areas have been observed as characteristic manifestations of aspergillosis.     

The effects of ultrasonic energy on peripheral nerves: implications for ultrasound-assisted liposuction

The integration of ultrasound-assisted liposuction with traditional suction-assisted lipoplasty has extended the role of liposuction in body contouring. Although there are ample data regarding the effects of ultrasound on peripheral nerves from studies with the Cavitron ultrasound surgical aspirator, there is little information concerning the effects of modern ultrasound body contouring equipment on neural tissue. This study was designed to evaluate the functional and histologic effects of ultrasound energy on rat peripheral nerves (sciatic nerves) using a commonly-used ultrasound-assisted liposuction generator. After the application of ultrasound to exposed rat sciatic nerves, operative magnification was used to assess any visible injury. The sciatic function index was serially measured to quantify immediate and long-term functional effects on the nerves. Our results showed immediate visible injury using low amplitude settings (level 6), but no functional evidence of injury until much higher settings were used (level 9). All animals in the groups with initial functional impairment had returned to normal or near-normal function at completion of the study (51 days). Histologic examination revealed no evidence of damage in the low amplitude groups. Histologic analysis of the high amplitude groups displayed diffuse infiltration of the nerve, with foamy histiocytes and an increased number of mast cells, consistent with remote neural injury followed by myelin breakdown and repair.     

Numerical study of the effect of ultrasound frequency on temperature distribution in layered tissue

The high intensity focused ultrasound (HIFU) technology can produce therapeutic benefits in deep-seated tissues of interest, selectively and noninvasively. In order to control the treatment process, it is important to recognize the heat generation in biological tissue and the parameters that have an effect on temperature rising. This study investigates the influence of frequency and source intensity on temperature distribution during high-intensity focused ultrasound (HIFU). A nonlinear full wave equation model is simulated to compute the pressure field. Additionally, the absorbed coefficient of tissue is added to the nonlinear equations to simulate accurately the wave propagation in tissue with high absorbed coefficient. In addition, temperature distribution was solved by the Pennes bio-heat equation. Conclusively, frequencies in the range of 1–1.5 MHz are prescribed to have maximum heat absorption in the focal region.     

Evaluation of biological effects induced by diagnostic ultrasound in the rat foetal tissues

In recent years, there has been growing interest in estimating the degree of heating caused by the diagnostic ultrasound in clinical practice. Both theoretical and experimental methods have been suggested for estimating the heating potential, or thermal hazard, of diagnostic ultrasound. Aim of this study was to evaluate in vivo effects of ultrasound exposure of variable duration (from 10 up to 20 min) with commercially available imaging systems commonly used for diagnostic imaging. Numerical results related to the thermal effect are obtained by simulation program based on B-mode (scanning) and Doppler (non-scanning). To investigate the biological effects of the ultrasound exposure to the brain and liver tissues, the antioxidant enzyme activity and thiobarbituric acid reactive substances (TBARS) of the tissues were evaluated. In liver tissue, as a lipid peroxidation index, TBARS levels very significantly increase in Doppler group compared to control. However, in B-mode, TBARS levels are the same with the control group. Use of B-mode in foetal tissue is more reliable than Doppler mode because temperature rise is very small compared to the Doppler mode. On the other hand, the antioxidant enzyme activities tend to increase in B-mode and Doppler groups compared to the control group as a defensive mechanism. In the brain tissue, lipid peroxidation is increased slightly in B-mode compared to the control group. This situation is related to the molecular structure of the brain tissue because of its high lipid concentration. In brain tissue, the antioxidant enzyme activities and lipid peroxidation were significantly increased, such as liver tissue in Doppler groups. Doppler ultrasound may produce harmful effects in rat foetus liver and brain tissues as a result of the high temperature rises.     

Targeted Delivery of GDNF through the Blood–Brain Barrier by MRI-Guided Focused Ultrasound

Neurotrophic factors, such as glial cell line-derived neurotrophic factor (GDNF), are promising therapeutic agents for neurodegenerative diseases. However, the application of GDNF to treat these diseases effectively is limited because the blood–brain barrier (BBB) prevents the local delivery of macromolecular therapeutic agents from entering the central nervous system (CNS). Focused ultrasound combined with microbubbles (MBs) using appropriate parameters has been previously demonstrated to be able to open the BBB locally and noninvasively. This study investigated the targeted delivery of GDNF MBs through the BBB by magnetic resonance imaging (MRI)-guided focused ultrasound. Evans Blue extravasation and histological examination were used to determine the optimum focused ultrasound parameters. Enzyme-linked immunosorbent assay was performed to verify the effects of GDNF bound on MBs using a biotin–avidin bridging chemistry method to promote GDNF delivery into the brain. The results showed that GDNF can be delivered locally and noninvasively into the CNS through the BBB using MRI-guided focused ultrasound combined with MBs under optimum parameters. MBs that bind GDNF combined with MRI-guided focused ultrasound may be an effective way of delivering neurotrophic factors directly into the CNS. The method described herein provides a potential means of treating patients with CNS diseases.     

Effects of MDL 72527, a Specific Inhibitor of Polyamine Oxidase, on Brain Edema, Ischemic Injury Volume, and Tissue Polyamine Levels in Rats After Temporary Middle Cerebral After Occlusion

Abstract The possible effects of the polyamine interconversion pathway on tissue polyamine levels, brain edema formation, and ischemic injury volume were studied by using a selective irreversible inhibitor, MDL 72527, of the interconversion pathway enzyme, polyamine oxidase. In an intraluminal suture occlusion model of middle coerebral artery in spontaneously hypertensive rats, 100 mg/kg MDL 72527 changed the brain edema formation from 85.7 ± 0.3 to 84.5 ± 0.9% in cortex ( P < 0.05) and from 79.9 ± 1.7 to 78.4 ± 2.0% in subcortex (difference not significant). Ischemic injury volume was reduced by 22% in the cortex ( P < 0.05) and 17% in the subcortex ( P < 0.05) after inhibition of polyamine oxidase by MDL 72527. There was an increase in tissue putrescine levels together with a decrease in spermine and spermidine levels at the ischemic site compared with the nonischemic site compared with the nonischemic site after ischemia-reperfusion injury. The increase in putrescine levels at the ischemic cortical and subcortical region was reduced by a mean of 45% with MDL 72527 treatment. These results suggest that the polyamine interconversion pathway has an important role in the postischemic increase ini putrescine levels and that blocking of this pathway can be neuroprotective against neuronal cell damage after temporary focal cerebral ischemia.     

Distribution of epidermal ridge minutiae

The distribution of epidermal ridge minutiae on the distal portion of male human thumbprints has been characterized. For each of 412 thumbprints, a centrally located focal minutia was chosen and neighboring minutiae were sampled. Minutiae were considered to be neighbors if there were no other minutiae appearing in the intervening region defined by the two minutia events and the ridge system. For each neighbor minutia, the total ridge distance between the focal and neighbor minutiae was measured. This distance is the total length of ridges appearing in the intervening region. The number of neighbor minutiae occurring about the focal minutia was found to be normally distributed with a mean of 6.42 (n = 412). The distribution of total ridge distances was not adequately described by the negative exponential distribution, but was well described by a gamma distribution with a shape parameter of 0.193 and a scale parameter of 5.91 mm. This gamma distribution reflects a local overdispersion of minutiae. This study is noteworthy as the first to describe the distribution of epidermal ridge minutiae within the ridge structure. The results support prior work based on quadrat sampling and eliminate two possible sources of error. A possible explanation for the overdispersed distribution lies in the growth stress model for minutia formation. Minutia formation may alleviate local growth stress, thereby removing the impetus for formation of additional minutiae in the immediately surrounding region.     

Activation of transgene expression in skeletal muscle by focused ultrasound

To correlate thermal dose from focused ultrasound (FUS) with gene expression and tissue injury, a temperature plateau strategy was employed. Plasmids encoding luciferase gene under the control of hsp70B promoter were transfected into the right gastrocnemius muscle in a rat via electroporation. One day after transfection, hind limbs were treated with 3.3-MHz focused ultrasound, using one of four different temperature plateaus with spatial-peak time-average focal temperatures (T_SPTA) of 46 °C, 48 °C, 51 °C and 62 °C. The treatment duration at the plateau temperature was varied from 0 to 30 s. Gene expression was analyzed in vivo one day following FUS treatment, and H&E staining was employed to assess tissue injury. Gene activation and tissue damage correlated closely with thermal dose. The highest level of gene activation was induced by FUS at T_SPTA = 51 °C for 20 s, which was found to be statistically equivalent to that produced by water-bath hyperthermia.     

Biological effects of two successive shock waves focused on liver tissues and melanoma cells

A new generator of two successive shock waves focused to a common focal point has been developed. Cylindrical pressure waves created by multichannel electrical discharges on two cylindrical composite anodes are focused by a metallic parabolic reflector - cathode, and near the focus they are transformed to strong shock waves. Schlieren photos of the focal region have demonstrated that mutual interaction of the two waves results in generation of a large number of secondary short-wavelength shocks. Interaction of the focused shockwaves with liver tissues and cancer cell suspensions was investigated. Localized injury of rabbit liver induced by the shock waves was demonstrated by magnetic resonance imaging. Histological analysis of liver samples taken from the injured region revealed that the transition between the injured and the healthy tissues is sharp. Suspension of melanoma B16 cells was exposed and the number of the surviving cells rapidly decreased with increasing number of shocks and only 8 % of cells survived 350 shocks. Photographs of cells demonstrate that even small number of shocks results in perforation of cell membranes.     

Down-regulation of the sodium channel Na(v)1.1 alpha-subunit following focal ischemic brain injury in rats: in situ hybridization and immunohistochemical analysis

Change in sodium channel (NaCh) activity can play a role in reorganization, recovery, or possibly excitotoxic damage after CNS injury. Alteration of sodium channel function has been reported to occur in a variety of neuropathological states including epilepsy and brain injury. Previously we reported that out of five NaCh alpha subunit genes that were down-regulated, Na(v)1.1 exhibited the most dramatic and sustained alterations following focal cerebral ischemia in the rat. In the present study, we evaluated the acute spatial and temporal time course distribution of Na(v)1.1 mRNA (in situ hybridization) and protein (immunohistochemistry) following ischemic brain injury. Male rats were subjected to 2 h of middle cerebral artery occlusion (MCAo) followed by reperfusion and brain tissue was collected at 2, 6, 24, and 48 h post-MCAo. Analysis of brain tissue revealed a qualitative drop in both mRNA and protein levels of Na(v)1.1 throughout ischemic regions, beginning at the early stage of injury (6 h) with dramatic losses at later stages (24 and 48 h). Quantitative cell counts and optical density measurements indicated significant decreases in the percent of brain cells immunoreactive for Na(v)1.1 as well as a loss of signal in those cells positive for Na(v)1.1 in the injured cortex and striatum as compared to the contralateral hemisphere. Double labeling with NeuN and Na(v)1.1 immunoflouresence confirmed that the predominate loss of Na(v)1.1 immunoreactivity was in neurons. In conclusion, these data map the time-dependent loss of Na(v)1.1 mRNA and protein following focal ischemic brain injury in the rat out to 48 h post-injury.     

The imaging and quantification of aluminium in the human brain using dynamic secondary ion mass spectrometry (SIMS).

Dynamic secondary ion mass spectrometry (SIMS) has been utilised to study the post-mortem distribution of aluminium in air-dried frozen sections from unfixed, unstained human brain in order to minimise contamination of the tissue and avoid redistribution and extraction of endogenous tissue aluminium. Substrates, sputter-coated with silver, were found to be free of focal aluminum surface contamination and thus minimised substrate induced artefacts in the tissue aluminium ion image. SIMS imaging of aluminium secondary ions at a mass resolution that eliminated the major molecular interferences, combined with a photomontage technique provided a unique strategy for studying aluminium distribution in tissue unrivalled by other spatially resolved microanalytical techniques such as laser microprobe mass spectrometry or X-ray microanalysis. Using this strategy, high densities of focal aluminium accumulations have been demonstrated in the cerebral cortex of the majority of chronic renal dialysis patients studied. In contrast, such aluminium accumulations were absent in control patients. SIMS imaging of aluminium appeared to provide much better discrimination between the dialysis patient group and the control group than one of the most widely used techniques for measuring aluminium in bulk samples, graphite furnace atomic absorption spectrometry. Preliminary studies have shown the feasibility of quantifying focal aluminium SIMS images obtained from brain tissue using aluminium-loaded brain homogenates as reference standards.     

Mechanisms for recovery of motor function following cortical damage

Recent studies of focal injury to the cerebral cortex have demonstrated that the remaining, intact tissue undergoes structural and functional changes that could play a substantial role in neurological recovery. New information regarding the molecular and cellular environment in the adjacent, intact tissue has suggested that waves of growth promotion and inhibition modulate the self-repair processes of the brain. Furthermore, recent studies have documented widespread neurophysiological and neuroanatomical changes in regions remote from a focal cortical injury, suggesting that entire cortical networks participate in the recovery process.     

高强度聚焦超声可治疗区域的仿真研究

数值仿真不同治疗参数条件下高强度聚焦超声(high intensity focused ultrasound,HIFU)可治疗区域的变化,对HIFU治疗剂量的确定具有重要的指导意义。本文采用Westervelt方程的近似式,结合Pennes生物热传导方程,以离体猪肝组织为例,在考虑组织声学特性对HIFU焦域温度场影响的条件下,通过时域有限差分法(finite difference time domain,FDTD)对HIFU焦域温度场进行仿真研究。研究结果表明,照射时间越长,组织声学特性的影响就越明显;焦点处的最高温升相同时,可治疗区域的大小差异较小;声强越大,形成可治疗区域所需的时间也越短;当声强一定时,随着照射时间的增加,可治疗区域的长、短轴长度均呈非线性增加;在相同可治疗区域的长轴或短轴长度一定时,输入声强和照射时间呈负相关。     

实验探索非靶组织光学参数对超声调制光的影响

生物组织是一种复杂的多层高散射介质,探索光在超声作用下的生物组织中的传播规律是超声调制光学成像术必须解决的一个基本问题,关系到最终进行图像处理与重建。通过实验探索超声调制光信号在双层和三层组织中的传播规律。实验结果表明非靶组织的光学属性（吸收系数和散射系数）和组织结构（单层或多层）都不影响超声调制光信号的调制深度。调制深度只与超声焦区介质（即靶组织）的声光属性有关,具有较佳的抗干扰性,适合用于图像重构。     

Characteristics of the formation of local destructive foci in brain tissues exposed to focused ultrasound

Local lesions produced in the different brain structures by focused ultrasound were investigated. It was revealed that the blood flow volume velocity had a considerable influence on temperature distribution in the focal area and on the threshold doses and lesion dimensions. Calculation of the lesion diameters on the basis of a purely heat model shows rather good accordance with the experimental data for the large hemispherical cortex and thalamic nuclei with a sufficiently long radiation time. A correlation was found between the subharmonic component of cavitation noise and appearance of the cavities, ruptures, and local hemorrhages located mainly on the boundaries between different cerebral tissues.